What is the Population Health Approach?

Population health reflects this shift in thinking about how health is defined. This broader notion of health recognizes the range of social, economic, physical and environmental factors that contribute to health. Population health refers to the health of a population as measured by health status indicators and as influenced by social, economic and physical environments, personal health practices, individual capacity and coping skills, human biology, early childhood development, and health services.

As an approach, population health focuses on the interrelated conditions and factors that influence the health of populations over the life course, identifies systematic variations in their patterns of occurrence, and applies the resulting knowledge to develop and implement policies and actions to improve the health and well-being of those populations.

A population health approach takes action based on analyses and understandings of the entire range of the determinants of health. Recognising the complex interplay between the determinants of health, it uses a variety of strategies and settings to act on the health determinants in partnership with sectors outside the traditional health system or sector.

A population health approach focuses on improving the health status of the population. Action is directed at the health of an entire population, or sub-population, rather than individuals. Focusing on the health of populations also necessitates the reduction in inequalities in health status between population groups. An underlying assumption of a population health approach is that reductions in health inequities require reductions in material and social inequities. The outcomes or benefits of a population health approach, therefore, extend beyond improved population health outcomes to include a sustainable and integrated health system, increased national growth and productivity, and strengthened social cohesion and citizen engagement.

Over the last fifty years, a change has emerged in the way health researchers and practitioners understand the factors that prevent chronic disease and lead to good health. Before that, it was largely considered a matter of bio-medical cause and effect, coupled with negative life style choices.

Health is a resource for every day life, not an object of living; it is a positive concept emphasising social and personal resources as well as physical capacities (Ottawa Charter for Health Promotion, WHO, 1986). The Ottawa Charter for Health Promotion also declared that health is “created and lived by people within the settings of their everyday life; where they learn, work, play and love.”

The overarching goals of a Population Health approach are to maintain and improve the health status of the entire population and to reduce inequities in health status in society. The Population Health approach is used in a number of well developed health systems throughout the world such as the Canadian health system.

Population health has been identified as a key concept and approach for policy and program development in Ireland. The National Health Strategy ‘Quality and Fairness’ (2001) states, “This Strategy iscentredon a whole-system approach to tackling health inIreland. It goes beyond the traditional concept of 'health services'. It is about developing a system in which best health and social well-being are valued and supported.”

The central role of a population health approach is reinforced within the structure of the Health Service Executive. The Population Health Directorate is positioned in the Health Service Executive to operationalise a population health approach and as a unifying force for the entire spectrum of health system interventions; from prevention and promotion to health protection, diagnosis, treatment and care; and to integrate and balance action between them. The Transformation programme requires a population health approach to underpin all service and corporate planning. (HSE National Service Plan 2006)

The HSE Transformation programme identifies the organisational mission and vision and the key programmes of work to transform the health service. Key transformation programmes include Programme four which aims to develop a framework for the prevention and management of chronic illness and to improve the health of the population. Developing and implementing a population health strategy is a key driver project within programme four, the development of which will support us in aiming to achieve our vision.

The HSE Transformation Programme has identified key challenges in how we will deliver health and social care services and improve health and social well being into the future. The international experience emphasises the importance of adopting a population health approach if we are to maximise this transformation process.

Chronic illness is defined as long term conditions which can be treated but not cured. These conditions include diabetes, heart failure, chronic obstructive pulmonary illness, dementia and mental health problems, asthma, musculoskeletal diseases, and a range of disabling neurological conditions, many of which are preventable.

The purpose of the framework is to identify the way forward so as to prevent chronic illness where possible and to detect, minimise and manage the impact of chronic illness on individuals and the population.

This statement was developed following a consultation process undertaken in the summer of 2007 to gather information towards developing the vision for population health and to get staff views on developing a common vision. Two hundred and fifty staff took part in this process facilitated by the HSE Organisational Development Service.